Acute and Late Toxicity in a Randomized Trial of Conventional Versus Hypofractionated Three-Dimensional Conformal Radiotherapy for Prostate Cancer

Arcangeli, Giorgio; Fowler, Jack F.; Gomellini, Sara; Arcangeli, Stefano; Saracino, Biancamaria; Petrongari, Maria Grazia; Benassi, Marcello; Strigari, Lidia

doi:10.1016/j.ijrobp.2009.12.045

Cited by 142 publications

(110 citation statements)

References 32 publications

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“…In this scenario, even though the OAR receives dose equivalent to the tumor dose ( the model predicts that hypofractionation will be preferable over multi-fractionation. This is consistent with recently published randomized trials where hypofractionated radiotherapy was better than conventional radiotherapy for prostate cancer (26,27). Previous radiobiological models predicted that hypofractionation is optimal for prostate cancer based on the fact that 0 0   is larger than…”

Section: Resultssupporting

confidence: 90%

A Mathematical Study to Select Fractionation Regimen Based on Physical Dose Distribution and the Linear–Quadratic Model

Mizuta

Sugiyama

Date

et al. 2012

International Journal of Radiation Oncology*Biology*Physics

107

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Mizuta 2 AbstractPurpose: Hypofractionated irradiation is often used in precise radiotherapy instead of conventional multi-fractionated irradiation. We propose a novel mathematical method for selecting a hypofractionated or multi-fractionated irradiation regime based on physical dose distribution adding to biological consideration.Methods and Materials: The linear quadratic (LQ) model was employed for the radiation effects on tumor and normal tissues, especially OARs. Based on the assumption that the OAR receives a fraction of the dose intended for the tumor, the minimization problem for the damage effect on the OAR was treated under the constraint that the radiation effect on the tumor is fixed.Results: For an N-time fractionated irradiation regime, the constraint of tumor lethality was described by an N-dimensional hypersphere. The total dose of the fractionated irradiations was considered for minimizing the damage effect on the OAR under the hypersphere condition. It was found that the advantage of hypofractionated or multi-fractionated irradiation therapies depends on the magnitude of the ratio of  parameters for the OAR and the tumor in the LQ model and the ratio of the dose for the OAR and the tumor.Conclusions: The present mathematical method shows that the multi-fractionated irradiation Mizuta 3 with a constant dose is better if the ratio of  for the OAR and the tumor is less than the ratio of the dose for the OAR and the tumor, while hypofractionated irradiation is better otherwise.

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Section: Resultssupporting

confidence: 90%

A Mathematical Study to Select Fractionation Regimen Based on Physical Dose Distribution and the Linear–Quadratic Model

Mizuta

Sugiyama

Date

et al. 2012

International Journal of Radiation Oncology*Biology*Physics

107

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“…Benign PSA bounces were common with 33.3% of all patients. The median time to PSA bounce was 13 months (range, [6][7][8][9][10][11][12][13][14][15][16][17][18]. The median height of PSA bounce was 0.34 ng/mL (range, 0.21-1.39).…”

Section: Resultsmentioning

confidence: 99%

“…The hypofractionated radiotherapy schema may improve the biochemical control of prostate cancer without increasing toxicities associated with late-responding tissue (8) . One phase III study trial suggested that hypofractionation regiment of 62 Gy in fractions is safe and acute and late complication were equivalent to that of the conventional fractionated regimen of 80 Gy in 40 fractions (10) .…”

Section: Introductionmentioning

confidence: 99%

Prostate-specific antigen kinetics after hypofractionated stereotactic body radiotherapy for localized prostate cancer

Kim

Phak

Kim

2016

IJRR

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Background: stereotac c body radiotherapy (SBRT) has emerged as an effec ve treatment for localized prostate cancer. However, prostate-specific an gen (PSA) kine cs a'er SBRT has not been well characterized. The objec ve of the current study is to analyze the rate of PSA decline and PSA nadir following hypofractonated SBRT in localized prostate cancer. Materials and Methods: From 2008 to 2014, thirty-nine pa ents newly diagnosed, localized prostate (25.6% low risk, 66.7% intermediate risk and 7.7% high risk) cancer were treated with SBRT using Cyberknife. Total dose of 36.25 Gy in 5 frac ons of 7.25 Gy were administered. No one received androgen depriva on therapy (ADT). PSA nadir and rate of change in PSA (slope) were calculated and compared. Results: With a median follow-up of 52 months (range, 13-71), the median rates of decline of PSA were -0.372, -0.211 and -0.128 ng/mL/month, respec vely, for dura ons of 1, 2 and 3 years a'er radiotherapy, respec vely. The decline of PSA was maximal in the first year and con nuously decreased for dura ons of 2 and 3 year. The median PSA nadir was 0.28 ng/mL a'er a median 33 months. There was one biochemical failure, occurring in a high risk pa ent. 5-year actuarial biochemical failure (BCF) free survival was 94.2%. Conclusion: In this report of localized prostate cancer, con nuous decrease of PSA level for dura on 1, 2 and 3 year following SBRT using Cyberknife resulted in lower PSA nadir. Also, SBRT leaded to long-term favorable BCF-free survival.

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“…26 Arcangeli et al used high dose EBRT in both groups but only included high-risk PC patients and had a limited follow-up time (median 33,5 months). 27 In contrast Lukka et al reported a 7% difference in biochemical or clinical failure favoring patients treated with a dose of 66 Gy in 33 fractions compared to the hypofractionated group who received 52,5 Gy in 20 fractions. 28 These poor results, however, can be explained by the low dose given in both groups.…”

Section: Hypofractionation In the Primary Setting For Pcmentioning

confidence: 93%

“…30 No significant differences in late toxicity are reported, although acute GI and GU toxicity seems to develop earlier in hypofractionated than in conventionally fractionated EBRT. 27 High dose hypofractionated EBRT has shown promising results, although long-term biochemical and clinical outcome and late toxicity reports are eagerly awaited. Furthermore, the ideal fractionation schemes are yet to be determined.…”

Section: Hypofractionation In the Primary Setting For Pcmentioning

confidence: 99%

Developments in External Beam Radiotherapy for Prostate Cancer

Lumen

Ost

Praet

et al. 2013

Urology

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Acute and Late Toxicity in a Randomized Trial of Conventional Versus Hypofractionated Three-Dimensional Conformal Radiotherapy for Prostate Cancer

Cited by 142 publications

References 32 publications

A Mathematical Study to Select Fractionation Regimen Based on Physical Dose Distribution and the Linear–Quadratic Model

A Mathematical Study to Select Fractionation Regimen Based on Physical Dose Distribution and the Linear–Quadratic Model

Prostate-specific antigen kinetics after hypofractionated stereotactic body radiotherapy for localized prostate cancer

Developments in External Beam Radiotherapy for Prostate Cancer

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